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Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection (SOLO II)

Primary Purpose

Wound Infection, Abscess, Systemic Inflammation

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Single-Dose IV Oritavancin Diphosphate
IV Vancomycin
Sponsored by
Melinta Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Wound Infection focused on measuring ABSSSI, Skin Infection, Abscess

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects may be included in the study if they meet all of the following inclusion criteria:

  1. Males or females ≥18 years old
  2. Diagnosis of ABSSSI suspected or confirmed to be caused by a Gram-positive pathogen requiring at least 5 days of IV therapy
  3. An ABSSSI includes one of the following infections Wound infections, Cellulitis/erysipelas, Major cutaneous abscess
  4. ABSSSI must present with at least 2 signs and symptoms
  5. Able to give informed consent and willing to comply with all required study procedures

Exclusion Criteria:

Subjects will be excluded from the study if any of the following exclusion criteria apply prior to randomization:

  1. Prior systemic or topical antibacterial therapy with activity against suspected or proven Gram-positive pathogens within the preceding 14 days

    • The causative Gram-positive pathogen(s) isolated from the ABSSSI site is resistant in vitro to the antibacterial(s) that was administered with documented clinical progression, or
    • Documented failure to previous ABSSSI antibiotic therapy is available. Documentation of treatment failure must be recorded
    • Patient received a single dose of a short acting antibacterial therapy three or more days before randomization
  2. Infections associated with, or in close proximity to, a prosthetic device
  3. Severe sepsis or refractory shock
  4. Known or suspected bacteremia at time of screening
  5. ABSSSI due to or associated with any of the following:

    • Infections suspected or documented to be caused by Gram-negative pathogens -- Wound infections (surgical or traumatic) and abscesses with only Gram-negative pathogens
    • Diabetic foot infections
    • Concomitant infection at another site not including a secondary ABSSSI lesion
    • Infected burns
    • A primary infection secondary to a pre-existing skin disease with associated inflammatory changes
    • Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease
    • Any evolving necrotizing process gangrene or infection suspected or proven to be caused by Clostridium species
    • Infections known to be caused by a Gram-positive organism with a vancomycin MIC >2 μg/mL or clinically failing prior therapy with glycopeptides
    • Catheter site infections
  6. Allergy or intolerance to aztreonam or metronidazole in a patient with suspected or proven polymicrobial wound infection involving Gram-negative and/or anaerobic bacteria
  7. Currently receiving chronic systemic immunosuppressive therapy
  8. AIDS with CD4 count < 200 cells/mm3
  9. Neutropenia
  10. Significant or life-threatening condition that would confound or interfere with the assessment of the ABSSSI
  11. Women who are pregnant or nursing
  12. History of immune-related hypersensitivity reaction to glycopeptides
  13. Patients that require anticoagulant monitoring with an aPTT
  14. Contraindication to vancomycin
  15. Patients unwilling to forego blood and/or blood product donation
  16. Treatment with investigational medicinal product within 30 days before enrollment and for the duration of the study
  17. Investigational device present, or removed <30 days before enrollment, or presence of device-related infection
  18. Patients unlikely to adhere to the protocol, comply with study drug administration, or complete the clinical study
  19. Severe hepatic disease
  20. Presence of hyperuricemia
  21. Unwilling to refrain from chronic use of any medication with antipyretic properties

Sites / Locations

  • Sharp Grossmont Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Single-Dose IV Oritavancin Diphosphate

IV Vancomycin

Arm Description

Outcomes

Primary Outcome Measures

Early Clinical Response
Clinical response at the ECE visit (48-72 hours following initiation of study drug administration). Early clinical response was defined as a composite outcome based on, cessation of spreading or reduction in the size of baseline lesion, absence of fever and no rescue antibiotic medication.

Secondary Outcome Measures

Investigator Assessed Clinical Cure at Post Therapy Evaluation (Key Secondary Endpoint)
Compared the clinical efficacy at the Post Therapy Evaluation of Oritavancin and Vancomycin based on the Investigator examination of the signs and symptoms of the primary ABSSSI; Investigator assessment of clinical cure is complete or nearly complete resolution of baseline signs and symptoms of the primary infection such that no further treatment with antibiotics is needed
>= 20% Reduction in Lesion Area
Clinical response at the ECE visit (48-72 hours following initiation of study drug administration) based on changes in ABSSSI lesion size measurements from baseline.

Full Information

First Posted
December 1, 2010
Last Updated
April 12, 2021
Sponsor
Melinta Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01252732
Brief Title
Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection
Acronym
SOLO II
Official Title
A Multicenter, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of Single-Dose IV Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection (SOLO II)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
December 2010 (undefined)
Primary Completion Date
June 2013 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Melinta Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this Phase 3 trial is to evaluate the efficacy, safety, and tolerability of oritavancin in ABSSSIs, including those caused by MRSA and to evaluate the potential economic benefit of oritavancin administered as a single 1200 mg IV dose.
Detailed Description
This is a Phase 3, multicenter, randomized, double-blind, parallel, comparative efficacy and safety study of single-dose IV oritavancin/IV placebo versus IV vancomycin for 7 to 10 days in adults with acute bacterial skin and skin structure infection (ABSSSI) suspected or proven to be caused by Gram-positive pathogens. Approximately 960 patients will be randomized at 100 centers globally. In addition, this study will characterize the PK and PK/PD properties of a single 1200 mg IV dose of oritavancin and evaluate the potential health economic benefits offered by this dosing strategy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wound Infection, Abscess, Systemic Inflammation, Cellulitis
Keywords
ABSSSI, Skin Infection, Abscess

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1019 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single-Dose IV Oritavancin Diphosphate
Arm Type
Experimental
Arm Title
IV Vancomycin
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Single-Dose IV Oritavancin Diphosphate
Intervention Description
Intravenous oritavancin and IV placebo or IV vancomycin will be administered for a minimum of 7 days up to a maximum of 10 days.
Intervention Type
Drug
Intervention Name(s)
IV Vancomycin
Intervention Description
Intravenous oritavancin and IV placebo or IV vancomycin will be administered for a minimum of 7 days up to a maximum of 10 days.
Primary Outcome Measure Information:
Title
Early Clinical Response
Description
Clinical response at the ECE visit (48-72 hours following initiation of study drug administration). Early clinical response was defined as a composite outcome based on, cessation of spreading or reduction in the size of baseline lesion, absence of fever and no rescue antibiotic medication.
Time Frame
48-72 hours after the initation of study therapy
Secondary Outcome Measure Information:
Title
Investigator Assessed Clinical Cure at Post Therapy Evaluation (Key Secondary Endpoint)
Description
Compared the clinical efficacy at the Post Therapy Evaluation of Oritavancin and Vancomycin based on the Investigator examination of the signs and symptoms of the primary ABSSSI; Investigator assessment of clinical cure is complete or nearly complete resolution of baseline signs and symptoms of the primary infection such that no further treatment with antibiotics is needed
Time Frame
7 to 14 days after end of therapy
Title
>= 20% Reduction in Lesion Area
Description
Clinical response at the ECE visit (48-72 hours following initiation of study drug administration) based on changes in ABSSSI lesion size measurements from baseline.
Time Frame
48-72 hours after the initation of study therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects may be included in the study if they meet all of the following inclusion criteria: Males or females ≥18 years old Diagnosis of ABSSSI suspected or confirmed to be caused by a Gram-positive pathogen requiring at least 5 days of IV therapy An ABSSSI includes one of the following infections Wound infections, Cellulitis/erysipelas, Major cutaneous abscess ABSSSI must present with at least 2 signs and symptoms Able to give informed consent and willing to comply with all required study procedures Exclusion Criteria: Subjects will be excluded from the study if any of the following exclusion criteria apply prior to randomization: Prior systemic or topical antibacterial therapy with activity against suspected or proven Gram-positive pathogens within the preceding 14 days The causative Gram-positive pathogen(s) isolated from the ABSSSI site is resistant in vitro to the antibacterial(s) that was administered with documented clinical progression, or Documented failure to previous ABSSSI antibiotic therapy is available. Documentation of treatment failure must be recorded Patient received a single dose of a short acting antibacterial therapy three or more days before randomization Infections associated with, or in close proximity to, a prosthetic device Severe sepsis or refractory shock Known or suspected bacteremia at time of screening ABSSSI due to or associated with any of the following: Infections suspected or documented to be caused by Gram-negative pathogens -- Wound infections (surgical or traumatic) and abscesses with only Gram-negative pathogens Diabetic foot infections Concomitant infection at another site not including a secondary ABSSSI lesion Infected burns A primary infection secondary to a pre-existing skin disease with associated inflammatory changes Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease Any evolving necrotizing process gangrene or infection suspected or proven to be caused by Clostridium species Infections known to be caused by a Gram-positive organism with a vancomycin MIC >2 μg/mL or clinically failing prior therapy with glycopeptides Catheter site infections Allergy or intolerance to aztreonam or metronidazole in a patient with suspected or proven polymicrobial wound infection involving Gram-negative and/or anaerobic bacteria Currently receiving chronic systemic immunosuppressive therapy AIDS with CD4 count < 200 cells/mm3 Neutropenia Significant or life-threatening condition that would confound or interfere with the assessment of the ABSSSI Women who are pregnant or nursing History of immune-related hypersensitivity reaction to glycopeptides Patients that require anticoagulant monitoring with an aPTT Contraindication to vancomycin Patients unwilling to forego blood and/or blood product donation Treatment with investigational medicinal product within 30 days before enrollment and for the duration of the study Investigational device present, or removed <30 days before enrollment, or presence of device-related infection Patients unlikely to adhere to the protocol, comply with study drug administration, or complete the clinical study Severe hepatic disease Presence of hyperuricemia Unwilling to refrain from chronic use of any medication with antipyretic properties
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
G. Ralph Corey, MD
Organizational Affiliation
Duke Clinical Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sharp Grossmont Hospital
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29358292
Citation
Corey GR, Loutit J, Moeck G, Wikler M, Dudley MN, O'Riordan W; SOLO I and SOLO II investigators. Single Intravenous Dose of Oritavancin for Treatment of Acute Skin and Skin Structure Infections Caused by Gram-Positive Bacteria: Summary of Safety Analysis from the Phase 3 SOLO Studies. Antimicrob Agents Chemother. 2018 Mar 27;62(4):e01919-17. doi: 10.1128/AAC.01919-17. Print 2018 Apr.
Results Reference
derived
PubMed Identifier
27370913
Citation
Deck DH, Jordan JM, Holland TL, Fan W, Wikler MA, Sulham KA, Ralph Corey G. Single-Dose Oritavancin Treatment of Acute Bacterial Skin and Skin Structure Infections: SOLO Trial Efficacy by Eron Severity and Management Setting. Infect Dis Ther. 2016 Sep;5(3):353-61. doi: 10.1007/s40121-016-0119-9. Epub 2016 Jul 1. Erratum In: Infect Dis Ther. 2016 Sep;5(3):363-5.
Results Reference
derived
PubMed Identifier
25294250
Citation
Corey GR, Good S, Jiang H, Moeck G, Wikler M, Green S, Manos P, Keech R, Singh R, Heller B, Bubnova N, O'Riordan W; SOLO II Investigators. Single-dose oritavancin versus 7-10 days of vancomycin in the treatment of gram-positive acute bacterial skin and skin structure infections: the SOLO II noninferiority study. Clin Infect Dis. 2015 Jan 15;60(2):254-62. doi: 10.1093/cid/ciu778. Epub 2014 Oct 6.
Results Reference
derived

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Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection

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